DRHOOK- Pay attention: ADD spottable in elementary school

the handsome doctor John Hong

"Huh?" Isn't that likely the most used word today? 

With smart phones, computers, music videos flashing different shots every other second, news info crawling under the news anchors themselves, and satellite radio beeping you when a favorite song plays on a different station, is it any surprise we're distracted? 

I used to think a lady putting on makeup at the red light was bad, but now I watch in amazement as drivers text message while steering with their knees.

Are we ADD or just distracted?

Attention Deficit Disorder (ADD) exists in as many as two to four percent of American adults because about a third of kids with ADD never "outgrow" it. ADD results from a lack of the brain chemicals that keep a person focused and able to process things in a timely matter. Sounds like Charlie Sheen.

ADD symptoms have to occur before the age of eight, so I ask my patients, "How would your third-grade teacher have described you?" 

If I hear, "I was always in detention for talking and not paying attention. I never listened when she spoke to me. I made careless mistakes in my schoolwork, and my parents said I never finished my chores– if I ever remembered.

"Details, details! Who cares about details? My classmates hated to play games with me because I never could wait my turn. That didn't matter because I never invited anyone to my house, maybe because I was too unorganized. 

"I was a free spirit and avoided anything that required long thought or sustained work. I always got into trouble for losing important things, especially necessary things: like my books and pencils in class, my keys to my house, my baseball glove for Little League. 

"I was always distracted by the simplest things– like a fly on the wall or a conversation at the next table. Before I knew it, I'd have forgotten what I was doing." (At this point I've already written a prescription for ADD meds.)

Not everyone talks like life is a big run-on sentence, but I have noticed in both my patients and casual friends that people with ADD are scattered-brained. Because the ADD person can't keep to one train of thought or ends up doing many tasks (all uncompleted), conversations are usually about 18 different things. 

One guy I knew for many years was so ADD that I could tell right away when he wasn't taking his medicines. On medicines, he usually came 15 minutes late. Off medicines, he always came 45-200 minutes late. 

From the time he left his house till he got to our house, he would stop off at Lowe's because the sink was still leaking, the door was still unhinged, and the bathroom had no light bulbs; drop by three friends' houses to see if they could help him with things he hated to do; run by the library to return books but then realize he forgot the books, visit the park because he saw some flowers he liked, the coffee house because he was distracted again– (ADD people love caffeine.) There was no use calling him because he always forgot his cell phone, and if he did by chance have it, he didn't listen when it rang.

Depression, anxiety, bipolar disorder, and substance abuse all have to be considered (and then treated if present) before making a diagnosis of ADD. In fact, a lot of folks with ADD also have another mental health issue. 

There is treatment, which I'll address in a future column. 

Huh? Oh! Not because I'm ADD: I've just run out of time!


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.